Healthcare Provider Details

I. General information

NPI: 1851308241
Provider Name (Legal Business Name): GABRIELLA LYNN MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 BATTLEFIELD BLVD N
CHESAPEAKE VA
23320-4900
US

IV. Provider business mailing address

3241 WESTERN BRANCH BLVD
CHESAPEAKE VA
23321-5260
US

V. Phone/Fax

Practice location:
  • Phone: 757-967-8622
  • Fax: 757-686-0541
Mailing address:
  • Phone: 757-686-3508
  • Fax: 757-686-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101224455
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101224455
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number0101224455
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: